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SLEEP-SMART Intervention Shows Promising Results for Women Suffering from Sleeping Problems, Depression, and Anxiety

June 21, 2021

By the first spring of the pandemic, women had “alarmingly high rates of mental health problems,” including depression and anxiety, according to a study published this spring in the Journal of Women’s Health. The researchers point to job losses and other severe stressors of the pandemic that have taken a greater toll on women, who make up the majority of essential workers and take on most family care responsibilities. We know that stress can lead to sleep difficulties, and prior research has shown that lack of sleep can contribute to and exacerbate health problems.

Women’s Health Research at Yale, with support from WHAM! Investigators Fund, sought a practical way to help older women improve their sleep and in doing so reduce health risks linked to insufficient sleep, such as depression, cardiovascular disease and Alzheimer’s disease.

WHRY partner Dr. Hilary Blumberg, the John and Hope Furth Professor of Psychiatric Neuroscience and Director of Yale’s Mood Disorders Research Program adapted a tested sleep intervention known as SLEEP-SMART to focus on helping older women with sleep problems and develop it for remote administration. In doing so, she was able to demonstrate a unique method for providing this population of women with strategies to improve their sleep health in a way that is accessible and potentially scalable for wide distribution.

“Even before COVID-19, women have had higher rates of sleep disturbances than men, which are more likely to worsen with age,” Blumberg said. “What we have seen during the pandemic is the emotional, cognitive, and physical cost to women when routines and then sleep become more irregular.”

As the country shut down last year and people isolated themselves to slow the virus’ spread, another aspect of SLEEP-SMART’s forward-thinking design showed that sessions of the intervention led by trained therapists could be mostly delivered via videoconferencing. In addition, recent advances in digital wearables, such as wrist “actigraphy” devices, provided her research team the capacity to study 24-hour patterns of activity.

Even before COVID-19, women have had higher rates of sleep disturbances than men, which are more likely to worsen with age.

Dr. Hilary Blumberg

“These technologies can help us reach women where they live, automatically collect data when they are in their natural environments, and maintain regular personal connections with therapists that reinforce the intervention’s goals,” Blumberg said.

Preliminary data indicate SLEEP-SMART can improve sleep patterns, show associated reductions in symptoms of depression and anxiety, and improve the functioning of brain circuits important in emotional and cognitive health. Participants also reported a capacity to create more consistent routines and fall asleep more easily that resulted in a clearer, more alert mind.

Dr. Blumberg plans to continue testing SLEEP-SMART and its potential for broad use.

Submitted by Rick Harrison on June 10, 2021


SLEEP-SMART, or Sleep Self-Monitoring And Regulation Therapy, is a 12-week intervention to regularize sleep and other daily rhythms that Dr. Hilary Blumberg, with colleagues at Yale and the University of Pittsburgh, adapted from an existing therapy called Social Rhythm Therapy.

The intervention is administered by a trained therapist working with individuals on strategies to promote healthier patterns of daily activities and sleep, such as setting a consistent bedtime with a comfortable room temperature and shutting off devices before lying down.